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HomeMy WebLinkAboutDrain Layers Permit 385 Nevers Road TOWN OF SOUTH WI N DSOR DEPARTMENT OF PUBLIC WORKS BUREAU OF POLLUTION CONTROL DRAIN LAYER'S 5362 tam 19�� Pursuant to written application, permission is hereby grante to the Licen a Drain Layer named herein to perform the work 'ndicated below at � r at premises owned by whose address is and to Lay House Drain Repair House Drain, Lay Main, Other , for occupancy or use, with Family Units, with acres. Type of Sewage to be connected under this permit: SANITARY SEWAGE V), INDUSTRIAL WASTES ( ), OR ( ) Connection will be made with Show sketch of proposed work car furnish two (2) copies of separate drawings. 3 "s W V, r ` SPECIAL CONDITIONS �0 Mzoe�t �, Desired Starting Date (} C T T— Estimated Time for Completion Permit to be issued to the holder of Drain Layer's License No. Permit will expire thirty (30) days after date of issuance. The undersigned Drain L yer hereby agrees to all the terms and conditions set forth in the permit and the reverse side thereof. Applicant has received Town Permit No. and/or, CHD Permit No. Signed X�L ki - Licensed Drain Layer The above named Drain Layer has a valid lice n a issued by the State of Connecticut and has filed a satisfactory bond and insurance policy'# tie name of h Town of South Windsor: X©17- i3/ E ginee epartment Date Connection Charge Paid �'� e it Fee: Paid $ Check umber ) (� Issued by Tax Office INSPECTION Date work started ® Date completed Ali Sufficient notification rec iv d: Yes No Special Conditions APPROVED: Ins ector e Construction Inspection Report Project note 12-5 Street Ti e°9�a Weather r 1 Developer Co actor Work in Progres r i Problem Areas Special Instruct ions/Orders